The BridgeBlog

By Lorraine Schnelle, CPA

There’s one thing that will never change at your practice or organization. That is patient satisfaction is critical to your success. As ICD-10 preparation activities occur, it’s important to recognize how your transition plans impact the patient’s experience.

Prior to implementing ICD-10, pay special attention to the tests or procedures that are scheduled for October 1, 2013 and after. Both the physician office and scheduling staff need to ensure the correct coding system is used based on the patient’s date of service and the payer. There may be situations where both an ICD-9-CM and ICD-10-CM code will need to be provided. If the appropriate codes are not provided, it could cause multiple delays in scheduling the service and have a negative effect on patient satisfaction.

Wait times may become longer if patient intake must review the order and third party payer to determine which coding system is applicable. Additionally, patient satisfaction may be further affected if intake must contact the physician’s office to clarify the diagnosis code.

As payers receive claims on or after October 1, 2013, there may be delays in the business office and/or as the payer processes the claims. This may result in slowed payment by payer(s) before a patient receives their portion of the medical bill. This may also bear negatively on patient satisfaction.

Even today, prior to implementing ICD-10, if eligibility determination is delayed or not completed prior to a patient receiving service — and ultimately the payer determines it wasn’t a covered benefit — a patient may be understandably upset. This is why it’s important to ensure any eligibility determination processes and procedures, including dual-coding situations, are reviewed and revised to help minimize patient dissatisfaction.

Stay tuned for next week’s post on financial results and ICD-10. Ready, set, go!

By Lorraine Schnelle, CPA

During normal operating cycles, most healthcare organizations do more with less to maximize cash flow — which can be difficult. Now, healthcare faces a major and all-important transition: the implementation of ICD-10 on October 1, 2013.

You may be involved right now in a project related to preparing for ICD-10. Let’s discuss a few reasons to prepare for a change in productivity.

Your organization may upgrade or install one or more new computer software programs; perhaps for the conversion to HIPAA Version 5010 or the transition to an electronic health record (EHR), or another clinical or financial initiative. Some of these upgrades will help prepare for ICD-10; others will help support quality or other programs.

Both the installation effort and system testing requires time and effort. Not only will the information technology (IT) department be involved; but others may be asked to help build and test the system’s functionality. Downtime is also a real possibility and can affect productivity. However, having redundant systems in place can reduce the chances of system downtime during an upgrade or implementation.

Now, we can’t forget that it takes time to learn how to use a new computer system; this process will likely add to the disruption in individual productivity.

What are some issues you can anticipate with a system upgrade implementation? It’s likely that there will be many ICD-10 planning meetings to discuss:

• Computer system issues;
• Processes and procedures;
• Payer issues and contracts;
• Education planning and preparation;
• And other project steps as they relate to converting to ICD-10.

Depending on the amount of time people need for the planning process, individual positions may need to be backfilled with additional staff to maintain day-to-day operations. What can you do to help minimize the impact this will have on productivity?

There may also be a loss in productivity and performance immediately after the transition to ICD-10, as we work with both ICD-9 and ICD-10 codes. Practices and organizations should prepare for processing claims with both ICD-9 and ICD-10 codes, leading to a dual-coding environment.

Adopting and applying these new processes and procedures will take time. How will you help ensure there is time to review and revise your organization’s processes and procedures prior to ICD-10?

Stay tuned for next week’s post on patient satisfaction and ICD-10. Ready, set, go!

By Lorraine Schnelle, CPA

Flash Forward to 2014

Flash forward to February 1, 2014, four months after your practice or organization has started using ICD-10 codes. As you review how well the transition went, what do you see?

Was your practice or organization successful in…maintaining coding accuracy and productivity; retaining a stable accounts receivable position; and sustaining a viable cash flow?

These three goals can’t be achieved without support from you and others during the implementation process. It’s the hard work and execution by many individuals in various roles that will lead to your organization’s successful transition to ICD-10.

It is imperative that everyone understand how they can influence financial outcomes and, more specifically, support workflow processes. To have a “This is very important to our success” attitude rather than a “This isn’t my problem” approach as it relates to the implementation of ICD-10 is crucial to a smooth transition. You must take ownership and personally commit to proactively preparing for this significant change. Otherwise, the view on February 1, 2014 may be disappointing and frustrating.

There are a lot of cogs in the ICD-10 wheel, focusing on only the coding aspect and skipping over the billing and technology outcomes; for example, you could see increased claims denials, declines in productivity, and other negative results. It will require hard work by many individuals in various roles to ensure your practice or organization successfully transitions to ICD-10.

By understanding the broad impact this change has on healthcare and, more specifically, your practice or organization, you can play a major role in minimizing potential negative outcomes, and begin to proactively work toward:

• Maintaining coding accuracy and productivity
• A stable accounts receivable position
• Sustaining cash flow

Over the next several weeks, we will creating additional blog posts focusing on the steps you can take within your organization to make this transition as smooth as possible. Ready, set, go!

The Centers for Medicare and Medicaid Services (CMS) recently announced it will provide a 90-day grace period for enforcement of HIPAA 5010. This doesn’t mean providers don’t have to comply with the requirement.

CMS will accept complaints about non-compliance with the rule and could require Covered Entities to show evidence of a good-faith effort to comply. In addition, any claim or bill submitted after January 1, 2012 not in HIPAA 5010 will still get rejected, but this delay will allow for resubmitting in the appropriate format without penalty.

Below are four tips to ensure reimbursement continues to occur at your organization after January 1, 2012:

1. With HIPAA 5010, the 837 transaction set now requires anesthesia services to be reported in minutes instead of units.

2. With the start of HIPAA 5010, the 835 transaction set offers new data elements; these will provide payers the ability to allow direct billing by a Medicaid agency to other health plans.

3. For Version 5010, the 837 transaction set provides for a present-on-admission indicator related to each diagnosis code.

4. The 270/271 transaction sets, with Version 5010, clarify instructions for patient hierarchy, such as when a subscriber is a patient and when a dependent is a patient.

For more HIPAA 5010 tips and information, sign-up for our monthly tips handout.

In a recent poll and study on the ICD-10 transition, 75% of healthcare professionals indicated deep concern over the conversion, while another 50% expect a loss of revenue. Respondents are concerned about staff training, understanding the new ICD codes, and increasing denials. Nearly half of all financial leaders who contributed to the study by HealthLeaders Media, ICD-10 Puts Revenue at Risk, anticipate a revenue loss of some kind from ICD-10. Even more significant, is that they anticipate losing margin over the next few years. The Importance of Education In the ICD-10 Puts Revenue at Risk study, Albert Oriol, the VP and CIO of Rady Children’s Hospital and Health Center in San Diego comments on the amount of learning that must take place prior to the conversion.

He says, “Many have compared ICD-10 to Y2K, [but] ICD-10 is more complex. It requires staff along the care continuum to learn and use a new order of magnitude of diagnostic and procedure codes—from the scheduler, to the physician, HIM professional and the biller. Unquestionably, ICD-10 introduces an added layer of complexity to the multitude of challenges already at hand.”

BridgeFront case studies can prove that revenue cycle staff education can improve employee productivity and increase accuracy; well-trained employees also have fewer denials, rejections, and re-bills. Staff education can clearly reduce the negative impact healthcare providers are expecting after the transition to ICD-10.

Informational Web Portal

BridgeFront recently announced its ICD-10 and HIPAA 5010 informational portal, located at www.icd10-education.com. Healthcare professionals can visit the website for complimentary resources on the conversions to ICD-10 and HIPAA 5010. Visitors can sign-up for a free on-demand webinar and a monthly preparation email newsletter.

ICD-10 and HIPAA 5010 Education by BridgeFront

BridgeFront also announces its ICD-10 and HIPAA 5010 online education. For more information, complete this form or contact us directly. Send an email to info@bridgefront.com or call 1-866-447-2211.

By Nancy Friedman, President of the Telephone Doctor

If your job entails taking calls or working with unhappy, irate customers, you’ve got your work cut out for you. Employees who work with this type of situation are especially vulnerable to outbursts from customers who are going through an emotional, stressful time.

Handling this type of customer takes time and training, but it can be accomplished effectively. Here are some of the Telephone Doctor’s best techniques for turning this situation into satisfied customers.

Get Off on The Right Foot

Realize that upset angry customers are not unhappy with you, but with the situation. Don’t take a customer’s hostility personally. You are merely the rod that redirects the violent lightening. You can do a great deal to diffuse the anger before you get to the customer. How? By smiling before you answer that call. You can really “hear” a smile over the phone. It’s very difficult to be rude to someone who is warm and friendly.

Four Steps to Handling the Irate Customer

There are four basic steps to handling an irate customer; we call them our ‘ASAP’ techniques.

A

Acknowledge the person’s feelings and apologize for the inconvenience the customer has encountered. Make an effort to be sincere. In today’s impersonal society, it’s incredibly rare to hear the words, “I’m sorry that happened. Let me get the ball rolling to fix it.” Those are MAGIC words. You’ll probably spend about 80 percent of your time massaging the caller’s feelings and 20 percent actually solving the problem.

S

Sympathize and empathize with the caller. Phrases like “I can understand why you’re upset” can help soothe ruffled feathers. Pretend it’s you calling. Then get busy solving the problem.

A

Accept 100 percent responsibility for the call. OWN IT. This is probably the toughest part. Chances are excellent that you had nothing to do with the problem. However, it’s your job to take the responsibility and help initiate a solution.

P

Prepare to help. Begin by re-introducing yourself – callers don’t usually remember your name. State that you will be able to help. Use the caller’s name, if possible. This helps to diffuse anger. A willing attitude is essential, because if the caller senses insincerity or indifference, it will cause them to stay angry. It’s exasperating to file a complaint with someone who obviously doesn’t care.

Excuses – When to Use Them

NEVER. Never make an excuse to a complaining caller. No one wants to hear “The computer is down” or “I’m the only one here.” That is your problem, not the caller’s problem. When you give an excuse, the caller automatically hears “I’m not going to help you.”

Transferring Calls

Sometimes you’re not able to solve the problem on the spot. Many times you need more information from another department. Perhaps the call needs to be handled by another person. Although these are legitimate courses of action, they usually upset your caller all over again.

If you need more information, TELL the caller. Ask them if they’re able to hold while you obtain it, or would they prefer a call back. “Joe, I need to check with our claims department in order to answer your question. It will take two or three minutes, are you able to hold/wait while I check?” Avoid untrue, frustrating phrases like “Hold on a second.” Nothing takes a second.

If you need to transfer a caller, if you can, let them know the name of the person they’ll be speaking with. It’s also good to explain a reason why you’re bringing in a third party. “Joe, Mrs. Smith in our claims department is the real expert in resolving your type of situation. May I transfer you directly to her?”

For more customer service tips, explore BridgeFront’s Customer Communications online education. Visit our website at www.bridgefront.com, send an email to info@bridgefront.com or call 1-866-447-2211.

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Reprinted with permission of Telephone Doctor Customer Service Training, St. Louis, MO. Nancy Friedman, president, is a featured speaker at association and corporate meetings. She has appeared on OPRAH, The Today Show, CNN, FOX News, Good Morning America, CBS This Morning and many others and has written articles for USA Today and the Wall Street Journal. For more information, log on to www.telephonedoctor.com or call 314-291-1012.

By Nancy Friedman, Telephone Doctor Customer Service Training

It never fails. When management is asked to name one characteristic they’d like to see in an employee, overwhelmingly it’s always OWNERSHIP; to take responsibility.

Certainly, there are other traits they’d like to see, but without fail OWNERSHIP wins. When we talk about “what does ownership mean to you” there are several answers. To make it easy, we’ve taken the word OWNERSHIP and labeled a thought to each letter.

O
Operate as though it’s your business. Take responsibility. There’s no, “It’s not my job” in ownership. There’s only, “I will help you.”

W
Walk in the customer’s shoes. That’s the best way to be sure you understand what’s going on and to help. Pretend it’s you calling in and needing the assistance. What if this happened to you?

N
Never say “NO.” That’s right; even when you’re not able to help or even when the situation is hopeless (and let’s hope it never gets to that). The word NO is offensive, abrupt, unfriendly, overused and tired. There are dozens of positive alternatives we can use to let the customer down gently. To offer a few: “I wish we could” or “Let me double check on that” or “I’m going to take some time and see if we can work this out.” Bottom line, offering NO at the top of your conversation is useless.

E
Empowerment is strength. Having employees empowered to assist by themselves is a strong motivation to do well. The worst they can do is make one mistake; normally, easily corrected and move forward. Empower your employees!

R
Resolution. Sticking with the issue until it is solved. No matter how many phone calls, how many times we re-check something; it’s not over till it’s fixed. Resolved! The mentality needs to be, “Your issues are our issues.”

S
Sending confirmation of the resolution. This is so important. If something gets fixed or resolved and the customer isn’t made aware of it, they can still be upset. The other day we were to have been issued a credit from an airline. We never heard from them. After a third call from my husband to the airline, we were told, “Oh, that credit was on your bill a few months ago.” But, no one bothered to let us know it was coming or that it had been done. Send confirmation or call! Then close the issue.

H
Happiness is key. Happy people love to help. That’s a fact. Your customers love to be helped by happy people. That’s another fact. They can even make the bitter better. (Say that three times fast!) Walk into your job HAPPY.

I
Integrity. This is non-negotiable. Having integrity is a huge part of ownership. Do what is right ALL the time. And remember, having the right to do it doesn’t always ‘make it right.’ Integrity!

P
Personal commitment. Each and every person helping a customer needs to make their own personal commitment that they will take ownership. No more, “It’s not my job.” No more, “I wasn’t here when it happened.” No more, “I don’t know anything about it.”

What does ownership mean to you? Let us know by commenting on this article or send a message on Twitter to @bridgefront.

For more customer service tips, explore BridgeFront’s Customer Communications online education. Visit our website at www.bridgefront.com, send an email to info@bridgefront.com or call 1-866-447-2211.

Reprinted with permission of Telephone Doctor Customer Service Training, St. Louis, MO. Nancy Friedman, president, is a featured speaker at association and corporate meetings. She has appeared on OPRAH, The Today Show, CNN, FOX News, Good Morning America, CBS This Morning and many others and has written articles for USA Today and the Wall Street Journal. For more information, log on to www.telephonedoctor.com or call 314-291-1012.

By Lorraine Schnelle, Co-Founder and EVP of BridgeFront

Remember sitting or standing in a circle and whispering something into the ear of the kid next to you…then watching the faces as your message was passed from person to person. The looks on each face ranged from confusion, surprise, and laughter as you all played the “telephone game.”

This picture popped into my head as I was thinking about a survey question I asked participants in a recent online webinar. The webinar was on educational tools and techniques. The attendees were primarily healthcare finance professionals—many of whom are responsible for managing one or more areas of the revenue cycle.

The survey question was, “What educational activity do you rely on most when delivering staff education?” The top two answers were on the job (OTJ) and one-on-one instruction.

Sounds to me like it could easily turn into the “telephone game” played out in our everyday work world. Don’t get me wrong, the National Training Laboratory found the average retention rate of students participating in “practice by doing” educational activities is 75%. Their study re-enforces the value of OTJ training.

However a word of caution, don’t rely on OTJ or verbal instruction as the main ‘source of truth.’ Because this same study found that only about 5% of what a student hears is retained.

Ensure you have additional educational activities and materials that are and will be used by your staff to support and re-enforce key learning concepts. This material can be in form of online courses, written procedures, video demonstration, work flow diagrams, user manuals, screen shot job aid, etc.

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For more information about BridgeFront’s online education, go to www.bridgefront.com or contact us directly. Call 1-866-447-2211 or send an email to info@bridgefront.com.

By Lorraine Schnelle, Co-Founder & EVP of BridgeFront

Improving the total patient experience is on the agenda of most healthcare organizations today. A newly published whitepaper suggests that customer service—throughout the revenue cycle—plays a vital role in the patient experience.

According to the whitepaper, The Revenue Cycle: An Essential Component in Improving Patient Experience by The Beryl Institute, good customer service—at each step of the revenue cycle process—is often more recognized by patients than quality healthcare; and good customer service often leads to increased patient satisfaction.

A typical revenue cycle in healthcare includes coding, insurance verification, third-party payers, financial counseling, billing, payment, or follow-up and collection. The whitepaper suggests that every step of the revenue process impacts the patient experience—beginning with the patient’s first interaction with the organization in scheduling his/her appointment, to discharge and communications with the finance department.

Here are four suggestions, noted in the whitepaper, for healthcare organizations to improve customer service at every step of the revenue cycle process:

1. Establish patient loyalty as an organization-wide goal
2. Educate employees on the new initiative
3. Train employees on essential interpersonal and soft skills
4. Ensure outsourced business providers also understand the new goals

The whitepaper’s research stems from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) annual survey. The HCAHPS survey is the first national, standardized, publicly reported survey of patients’ perspectives of hospital care.

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BridgeFront is a leading provider of revenue cycle and customer service online education. For more information on BridgeFront, go to www.bridgefront.com. If you have specific questions, please contact us directly. Send an email to info@bridgefront.com or call (866) 447-2211.

By Kent Lane, COO of BridgeFront

Companies with new products generally lack good customer support at the beginning of their product launch. However, when you find a product and company that does break the mold, you should shout about it—and ’shouting’ is what the new company Yard Rents just did.

Yard Rents is a new business in the Portland area. Essentially, they’re an outdoor and indoor equipment rental company that delivers and picks up what you need, when you want it and where you need it. Simply go online, select what you need and then ‘presto’ there they are with a van full of what you ordered.

This company is a perfect merger of internet freedom plus real live customer service. Upon delivery, they helped connect the equipment, instruct me on the usage, test the starting of the engine … and even made sure that I was wearing the right safety devices.

“Holly paradigm shift Batman!” (If you are old enough to remember the TV series Batman and Robin, you enjoyed that quote … if not old enough, sorry.)

These guys have taken the aloof sense of the internet and personalized it to the point where I feel as connected to them as I do any brick and mortar company I do business with. No more will I haunt rental companies, stand in their lines, and tout heavy equipment around … never again. Just point click and open the front door to a smiling, knowledgeable Yard Rents team member.

See them at www.yardrents.com (Portland, Oregon area only for now).

And … while you’re in the learning mood, take a look at your customer service departments. Would someone ’shout’ about them? One look and you may see a cross section of employees that certainly know how to communicate electronically…but can they successfully communicate to your patients and clients?

Give them the training they need to become ambassadors of your organization.  Our ‘Communicating with Customers’ e-learning series will transform any text’er to a successful verbal communicator. Courses are about 20 minutes each, and include real-life experiences and expert tips to handle any situation. Act today; take a look online and then call us at (866) 447-2211. Mention this blog post and get an additional 5% off.